Advanced liver fibrosis and the metabolic syndrome in a primary care setting

2021 ◽  
Author(s):  
Andrew D. Schreiner ◽  
Jingwen Zhang ◽  
Valerie Durkalski‐Mauldin ◽  
Sherry Livingston ◽  
Justin Marsden ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Liver Fibrosis ◽  
Care Setting ◽  
Primary Care Setting ◽  
The Metabolic Syndrome ◽  
Advanced Liver Fibrosis

Diagnostic accuracy of transient elastography (FibroScan) versus the aspartate transaminase to platelet ratio index in assessing liver fibrosis in chronic hepatitis B: The role in primary care setting

2011 ◽  
Vol 64 (10) ◽  
pp. 916-920 ◽  
Author(s):  
C Rinaldi A Lesmana ◽  
Simon Salim ◽  
Irsan Hasan ◽  
Andri S Sulaiman ◽  
Rino A Gani ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis B ◽  
Care Setting ◽  
Primary Care Setting ◽  
Transient Elastography ◽  
Liver Stiffness

BackgroundA non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative.ObjectivesThis study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients.Patients and MethodsA cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (109/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more.Results117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5–48 kPa) and the median APRI was 0.239 (0.09–2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy.ConclusionAPRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.

scholarly journals Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
M. Demede ◽  
A. Pandey ◽  
F. Zizi ◽  
R. Bachmann ◽  
M. Donat ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Resistant Hypertension ◽  
Evaluation System ◽  
Care Setting ◽  
Primary Care Setting ◽  
Obstructive Sleep ◽  
Risk Evaluation System

We ascertained the prevalence of resistant hypertension (RH) among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA) than hypertensives.Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO), a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61%) with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES), defining high risk as a total ARES score ≥6.Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03–5.88,P<.05).Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3–29%). However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension.

scholarly journals Risk factors for advanced liver fibrosis in HIV-infected individuals: role of the metabolic syndrome

2008 ◽  
Vol 11 (Suppl 1) ◽  
pp. P137
Author(s):  
F Blanco ◽  
P Barreiro ◽  
P Ryan ◽  
E Vispo ◽  
L Martin-Carbonero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Liver Fibrosis ◽  
The Metabolic Syndrome ◽  
Advanced Liver Fibrosis

scholarly journals High prevalence of metabolic syndrome in patients with hand osteoarthritis in a primary care setting

2012 ◽  
Vol 20 ◽  
pp. S159-S160
Author(s):  
C. Orellana ◽  
N. Navarro ◽  
J. Calvet ◽  
M. García-Manrique ◽  
J. Gratacós ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Care Setting ◽  
Primary Care Setting ◽  
Hand Osteoarthritis ◽  
High Prevalence

METABOLIC SYNDROME IN THE POPULATION ATTENDED IN PRIMARY CARE SETTING

2011 ◽  
Vol 29 ◽  
pp. e299-e300
Author(s):  
F. Valls-Roca ◽  
V. Pallares-Carratala ◽  
V. Gil-Guillen ◽  
D. Orozco-Beltran ◽  
J. L. Llisterri-Caro ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Care Setting ◽  
Primary Care Setting

1499: The Prevalence of LUTS and Prostate Enlargement in the Primary Care Setting

2007 ◽  
Vol 177 (4S) ◽  
pp. 494-495 ◽  
Author(s):  
Michael Naslund ◽  
Alicia Gilsenan ◽  
Kirk Midkiff ◽  
Eric Wolford ◽  
Aileen Bown ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Prostate Enlargement

Recognizing and Treating PTSD in the Primary Care Setting

2008 ◽  
Author(s):  
Ruth Elaine Graves ◽  
Tanya N. Alim ◽  
Notalelomwan Aigbogun ◽  
Thomas A. Mellman ◽  
William B. Lawson
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting
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